title: Association of adiponectin with peripheral muscle status in elderly patients with heart failure.
abstract: BACKGROUND
  Reduced peripheral muscle mass was demonstrated in patients with chronic heart failure (HF). Adipokines may have potent metabolic effects on skeletal muscle. The associations between adipokines, peripheral muscle mass, and muscle function have been poorly investigated in patients with HF.
  
  
  METHODS
  We measured markers of fat and bone metabolism (adiponectin, leptin, 25-hydroxy vitamin D, parathyroid hormone, osteoprotegerin, RANKL), N-terminal pro B-type natriuretic peptide (NT-pro-BNP) in 73 non-cachectic, non-diabetic, male patients with chronic HF (age: 68 ± 7 years, New York Heart Association class II/III: 76/26%, left ventricular ejection fraction 29 ± 8%) and 20 healthy controls of similar age. Lean mass as a measure of skeletal muscle mass was measured by dual energy X-ray absorptiometry (DEXA), while muscle strength was assessed by hand grip strength measured by Jamar dynamometer.
  
  
  RESULTS
  Serum levels of adiponectin, parathyroid hormone, osteoprotegerin, RANKL, and NT-pro-BNP were elevated in patients with chronic HF compared to healthy controls (all p<0.0001), while no difference in serum levels of leptin, testosterone or SHBG was noted. Levels of 25-hydroxy vitamin D were reduced (p=0.002) in HF group. Peripheral lean mass and hand grip strength were reduced in patients with HF compared to healthy subjects (p=0.006 and p<0.0001, respectively). Using backward selection multivariable regression, serum levels of increased adiponectin remained significantly associated with reduced arm lean mass and muscle strength.
  
  
  CONCLUSIONS
  Our findings may indicate a cross-sectional metabolic association of increased serum adiponectin with reduced peripheral muscle mass and muscle strength in non-cachectic, non-diabetic, elderly HF patients.
authors.affiliation: Cardiology Department, Zvezdara University Medical Center, Belgrade, Serbia. Electronic address: loncar_goran@yahoo.com.
authors.forename: Goran
authors.initials: G
authors.lastname: Loncar
authors.forename: Biljana
authors.initials: B
authors.lastname: Bozic
authors.forename: Stephan
authors.initials: S
authors.lastname: von Haehling
authors.forename: Hans-Dirk
authors.initials: HD
authors.lastname: Düngen
authors.forename: Nenad
authors.initials: N
authors.lastname: Prodanovic
authors.forename: Mitja
authors.initials: M
authors.lastname: Lainscak
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Arandjelovic
authors.forename: Sinisa
authors.initials: S
authors.lastname: Dimkovic
authors.forename: Zoran
authors.initials: Z
authors.lastname: Radojicic
authors.forename: Vera
authors.initials: V
authors.lastname: Popovic
mesh_terms: D015502:Absorptiometry, Photon; D052242:Adiponectin / Q000097:blood*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D016022:Case-Control Studies; D018737:Hand Strength / Q000502:physiology; D006333:Heart Failure / Q000097:blood* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D053581:Muscle Strength Dynamometer; D018908:Muscle Weakness / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012044:Regression Analysis
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers
keywords: 25(OH)D; 25-hydroxy vitamin D; Adiponectin; Chronic heart failure; HF; LVEF; Muscle mass; Muscle strength; N-terminal pro-brain natriuretic peptide; NT-pro-BNP; PTH; RANKL; heart failure; high sensitivity C-reactive protein; hs-CRP; left ventricular ejection fraction; parathyroid hormone; receptor activator of nuclear factor κB ligand